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SANJOAQUIN <br />, COUNTY— <br />' Greotness grows here <br />Boring Inspection Report <br />CONSTRUCTION <br />Total Depth: <br />Drilling Rig Type: <br />Min 2" Annular EHD Seal Verified: El Yes 0No <br />To: <br />To: <br />To: <br />To: <br />COMPLETION 1E1 Stove Pipe <br />ca8 irxg <br />height <br />0Christie Box <br />C0-183IS1Y42.,OX • <br />COMPLETIgN <br />Screen Length <br />Filter Pack <br />Bentonite <br />Grout <br />From: <br />From: <br />From: <br />From: <br />Environmer Health Department <br />Monitoring Well/Soil <br />Date: ‘1kAil Inspector: )4t0v—r) <br />Facility Address: OW <br />Well Well Address: <br />WP# —1D ) Et..., -3 <br />Soil Boring#: <br />Drilling Company: P.e,",,d-gor.e- <br />Driller Onsite: l'a.•...)k04-••••••-) <br />Consultant: <br />Geologist: <br />Public Water System Onsite: <br />0 Yes 0No <br />Domestic Well Onsite: <br />0 Yes 0No <br />If yes, location and distance: <br />SAMPLING <br />Holding Temperature: <br />Method: <br />Screening Method: <br /> <br />Verified Chain of Custody: <br />0 Yes 0No <br />SPOILS <br />Contamination Noted: 0 Yes 0 No <br />If yes, spoils storage Location: <br />Covered: 111 Yes LINo <br />If yes, material: <br />GROUTING or DESTRUCTION Total Depth: <br />Depth to Water: 32..R7 <br />Grout Material: <br />Gallons of Grout Used: a v.75 i tvo, <br />0Well Installation EeIl Destruction <br />0Boring Installation LI Boring Destruction <br />METHOD USED <br />0Pressure Grout IE-6ver Drill <br />0 Gravity El Other: <br />Water <br />gallons <br />Cement 471b <br />Bags <br />Water <br />gallons <br />cement 941b <br />Bags <br />Thickest Thinnest # Bags Thickest Thinnest 4 Bags <br />2,5 5 1 5 10 1 <br />5 10 2 10 20 2 <br />7,5 15 3 15 30 3 <br />10 20 4 20 40 4 <br />12.5 25 5 .25 50 5 <br />15 30 6 30 60 6 <br />17,5 35 7 35 70 7 <br />20 40 8 40 80 a <br />MATERIALS/DEVELOPMENT <br />Casing Type: <br />Blank Feet Screen Feet <br />Slot Size: <br />Bags of Cement: <br />Bags Sand/Gravel: <br />Type/Brand of Bentonite: <br />Filter Pack Type/Size: <br />Type of Method: <br />Bentonite/Cement Mix 3% Mix 5% Mix <br />Bentonite per 47 lb 1.41 2.47 <br />Bentonite per 94 lb 2.82 4.7 <br />10/16 /2 017 <br />1868 E. Hazelton Avenue I Stockton, California 95205 I T 209 468-3420 I F 209 464-0138 I www.sicehd.com